ergot derivatives lectue 4.pptx dddddddddddddddddd

medicine for midwife

1. Drugs used in labor and pph By nuh

2. Ergot alkaloids Ergot alkaloids are either natural or semi synthetic Preparations Ergometrine- 0.25mg/ 0.5mg ampoules & 0.5-1mg tablets Methergine - 0.2 mg ampoules & 0.5-1mg tablets Syntometrine Ergometrine - 0.5 mg+ syntocinon 5.0 units ampoules

3. Cont.. Ergometrine & Methergine can be used parenterally or orally. As the drug produces titanic uterine contractions, it should only be used after delivery of the anterior shoulder or following delivery of baby.  It should not be used in induction of labor or abortion.  Syntometrine should always be administered IM

4. Mode of Action Ergometrine acts directly on the myometrium. It stimulates uterine contractions & decreases bleeding

5. indications Therapeutic 1To stop the atonic uterine bleeding following delivery, abortion/ expulsion of hydatidiform mole Prophylactic  As a prophylaxis against excessive hemorrhage , it may be administered after the delivery of the anterior shoulder with crowing / following delivery of baby.

6. Contraindications 1. Suspected pleural pregnancy 2. Organic cardiac disease 3. Severe Pre-eclampsia & Eclampsia

7. Adverse effects 1. Rise of BP due to vasoconstriction action 2. Prolonged use in puerperium may interfere by decrease concentration of prolactin & gangrene of toes due to vasoconstriction .

8. Dosage and routes of administration For active management of 3rd stage of labour -0.2mg( iamp ) to be given IM. For control of atonic PPH -1amp slowly over 60 seconds, may be repeated after 2hrs. For excessive lochia and subinvolution-1 Tablet(0.125mg)TDS for 3 days.

9. Nursing consideration 1. Assess patient BP, pulse, respiration, signs of hemorrhage 2. Administer Orally/IM deep, have emergency cart readily available 3. Evaluate for decrease blood loss 4. Advised patient to report for increased blood loss, abdominal cramps, headache, sweating, nausea, vomiting/ dyspnea